Healthcare Provider Details

I. General information

NPI: 1316991003
Provider Name (Legal Business Name): ALEXANDER C BATCHEV DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 12/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2057 W 8TH ST #1
ERIE PA
16505
US

IV. Provider business mailing address

PO BOX 791
NORTHBROOK IL
60065-0791
US

V. Phone/Fax

Practice location:
  • Phone: 814-520-0411
  • Fax: 224-235-4652
Mailing address:
  • Phone: 847-593-8460
  • Fax: 224-235-4652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberOS014963
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS14963
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34.009399
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: